A Growing Grasp On Life Doctors' Touch Gives Fingers To Boy With Birth Defect

August 30, 1987|By Cory Jo Lancaster of The Sentinel Staff

PALM BAY — With the help of a new technique developed by two Orlando surgeons, a 3- year-old Palm Bay boy with a congenital hand defect is slowly growing two miniature fingers.

Instead of fingers on his right hand, Zachary Fallon was born with small pouches of skin where the fingers should have grown. He has five little bones around the top of his hand, but no bones in his palm and no knuckles.

For years his parents searched for orthopedic and plastic surgeons to give Zachary a functional hand. They consulted doctors nationwide before reaching two Orlando doctors who agreed to perform a special technique to give Zachary fingers.

At age 3, Zachary does not understand fully the problems with his hand. He only knows that he has a ''big hand'' and a ''little hand.''

''We explained the whole operation to him,'' said Zachary's father, Kenneth, an airplane mechanic at Harris Corp. in Melbourne.

''He knew everything that was happening. He kept saying, 'I'm going to get fingers,' '' he said.

The technique calls for transferring a small toe bone to serve as a miniature finger while the child is young enough that the bone will continue to grow along with the rest of the child's body.

It has been used successfully on children less than six months old, but after that age, the toe bones often have failed to grow, said Orlando hand and microvascular surgeon George White.

Because Zachary was almost 3 when doctors performed the operation, the doctors tried to increase the chances of growth by also transplanting a large blood vessel with the toe bones. The blood vessel, doctors believed, would trick the brain into making the bones grow.

It was the first time a blood vessel had been transplanted using the toe- to-hand technique, White said.

Only two bones were taken from Zachary's toes and were used to build an an index and middle finger.

In March, White and Orlando plastic surgeon Barry Boyd performed the six- hour operation at Florida Hospital in Orlando.

Afterward, the family and Zachary waited to see if the bones would grow.

After taking X-rays and measuring the bones two weeks ago, doctors discovered they had grown about a millimeter each, or about 0.04 of an inch, in six months.

The two doctors now believe that the operation, which was once performed only on infants, can be used to help children up to 5 years old with congenital hand defects.

''The two bones have grown exactly what we had predicted,'' White said.

If the bones continue to grow along with the rest of Zachary's body, the fingers should grow to be an inch long. The short fingers will enable Zachary to pick up and hold objects.

''The whole object of this is not to make him a normal hand -- we can't do that,'' White explained. ''All we can do is make him a functional hand -- one that can pinch and grab.''

When Zachary is 5, he will have a second operation to correct his thumb, which is shorter than normal and faces backward.

Doctors will elongate the thumb and rotate it to enable Zachary to pick up things.

''We will wait to see how much growth he has in the next few years before we decide exactly what to do,'' said Boyd.

Zachary's parents and doctors said they do not know what caused his hand defect, but his parents believe it might have been caused by his father's exposure to Agent Orange while serving as a Marine in Vietnam.

The family has logged a claim with the Veteran's Administration to share in a multimillion dollar settlement over the chemical defoliant.

There has been no research tying Agent Orange to Zachary's birth defect, but the family believes future research may find evidence of it.